The eye condition, ‘Blepharitis’, is an inflammation of the eyelids characterised by red, irritated and/or itchy eyes. It is frequently caused by bacterial infections but is also associated with skin conditions such as acne rosacea and dandruff of the scalp. There are two distinct forms of this condition that may occur concurrently: anterior blepharitis which is characterised by inflammation of the eyelid at the base of the eyelashes and posterior blepharitis, which describes inflammation of the modified sebaceous glands of the eyelid.
The modified sebaceous glands secrete an oily compound that contributes to the tear film of the eye. This secretion has various functions including:    1) Prevention of tear overflow;    2) Formation of a watertight seal on the closure of the eyelids;    3) Prevention of maceration of the lid-margin skin by tears;    4) Retardation of evaporation of the tear film;    5) Prevention of contamination of the tear film by the secretions of unmodified skin sebaceous glands;    6) Lowering the surface tension of tears resulting in thickening of the aqueous phase; and    7) Providing a smooth surface for the refraction of light.
Inflammation of the modified sebaceous glands is linked to a change in the lipid content or hyperkeratinisation of the gland's central duct. Changes such as these may be triggered by factors such as increasing age or alterations to a person's diet or hormone levels. Both of these underlying pathologies result in the obstruction of the outflow from the duct. If the gland is blocked it may swell up and cause a painless lump on the eyelid, or this swollen gland may become infected resulting in a painful red pustular mass in the eyelid. Eventually the gland becomes fibrosed and is permanently destroyed. Fibrosed glands often result in a loss of the normal anatomy of the eyelids resulting in increased tear film instability and eyelashes may become misdirected resulting in them growing towards the cornea causing a great deal of irritation to the patient. Loss of function and eventual loss in the number of glands results in a reduction in the oil component of the tear film. This is a leading cause of dry eye syndrome.
Known methods for treating the inflammation of the modified sebaceous glands include the application of hot compresses and subsequent manipulation of the eyelid. The hot compress “melts” or substantially decreases the viscosity of the modified sebum build up within the gland and subsequent massage may be effective in expressing the less viscous modified sebum from the gland. There are obvious drawbacks associated with this method, such as:    1) contamination by unsterilised items touching the eye and potentially worsening any infection already present;    2) potentially overheating the eye causing damage and discomfort;    3) not applying sufficient heat to treat the disease resulting in high recurrence and poor compliance; and    4) not massaging the lids for a sufficient amount of time or using an ineffective massage action.
Prior art devices designed for use on the eyelids include devices that either apply heat or massaging or a combination of heat and massaging to the lids. These limited steps effectively only deal with the blocked modified sebaceous glands. However, additional treatments designed to cleanse and remove debris from the eyelashes are often required. Furthermore, it is known that treating anterior blepharitis at the same time as posterior blepharitis leads to a reduction in the recurrence of posterior blepharitis.
Known methods for scrubbing the lashes are either the use of cotton wool or a woven cloth like material. Patients are often asked to make their own concentrate mixture of an un-medicated soap solution.
The complex regime of applying hot compresses, massaging the eyelid and cleansing the lashes often results in poor patient compliance. It takes time to perform each function correctly and a good level of dexterity is required. As blepharitis occurs more commonly in older patients, these technical challenges can result in even lower rates of patient compliance.
In addition, the fact that the treatment regime consists of multiple functions increases the likelihood that patients will only adequately treat one element of their disease, for example the blocked sebaceous glands. Only treating one element of the disease can result in much higher recurrence rates and therefore greater potential for the long-term loss of the limited number of glands in the eye.
The inventors have previously identified the need to treat the multiple elements of blepharitis simultaneously in order to improve patient compliance and reduce disease recurrence. A device for heating and massaging the eyelid with concomitant scrubbing of the lash bases is disclosed in patent application number WO 2009/066077. However, this particular art-known massaging apparatus is expensive to manufacture due to its complexity and has some other drawbacks which the present invention aims to ameliorate.
One of the drawbacks of the prior art device is inefficient heat transfer from the heating element to the surface in contact with the eyelid. As a result, the apparatus needs to be heated to high temperatures in order to transfer sufficient heat to the eyelid. The inefficient heat transfer also means the apparatus requires a few minutes to attain the required temperature prior to use, which significantly increases the overall time required to perform the treatment. In addition, this shortcoming necessitates a microchip controller and an alarm system to alert the end-user to when the device is ready thereby increasing the manufacturing costs of the apparatus.
Furthermore, a high amount of energy is required to power the prior art device. This either means that batteries need to be changed extremely frequently or the device needs to be connected to mains power in use. This results in high running costs resulting potentially poor patient compliance or expense for inclusion of mains power chord.
The prior art device has a massaging nodule that describes a circular path therefore in order to treat both halves of the eyelid in the desired direction, the massaging apparatus needs to alternate between rotating clockwise and rotating anticlockwise during a single treatment. This necessitates either a manual or an automatic switch to reverse the direction of the motor and alternate the rotation of the massaging nodule, incurring additional cost in manufacture.
It is an object of the present invention to provide a device that overcomes the shortcomings of the prior art devices, and in particular, to reduce manufacturing costs and make it easier for patients to use.
It is also the object of the present invention to provide a device with an improved massaging action to more effectively treat inflammation of the eyelid and reduce recurrence, or at least to provide the public with a useful alternative.